Jesse Lockhart JR. PA-C

NPI 1316121106 - Physician Assistant - 363A00000X

NPI Details
NPI 1316121106
Gender Male
Enumeration Date 12/28/2007
Last Updated 05/27/2015
Entity Type Individual
Active Over 8 years ago
Practice Location
5669 WHITESVILLE RD
COLUMBUS GA, 31904, US
Phone (706) 571-7246
Fax (706) 571-7264
Business Location
5669 WHITESVILLE RD
SOUTHEAST REGIONAL PAIN CENTER
COLUMBUS GA, 31904, US
Phone (706) 571-7246
Fax (706) 571-7264
Toxanomy
Taxonomy Code 363A00000X
License State Georgia
License Number 3983
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According to our database, Mr. Jesse Lockhart JR. PA-C NPI is 1316121106, taxonomy code is 363A00000X and license number is 3983, license state is located at Georgia. Jesse Lockhart JR. PA-C physically located at 5669 Whitesville Rd, Columbus GA, 31904. NPI Number Jesse Lockhart JR. PA-C has the Individual type.

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1316121106 NPI number is provided on an as is basis without warranty of any kind. 1316121106 is maintained by the National Plan & Provider Enumeration System. The contents of Jesse Lockhart JR. PA-C are for informational purposes only.